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04.09.2015 | Ultrasound

Strain ratio ultrasound elastography increases the accuracy of colour-Doppler ultrasound in the evaluation of Thy-3 nodules. A bi-centre university experience

verfasst von: Vito Cantisani, Piero Maceroni, Vito D’Andrea, Gregorio Patrizi, Mattia Di Segni, Corrado De Vito, Hektor Grazhdani, Andrea M. Isidori, Elisa Giannetta, Adriano Redler, Fabrizio Frattaroli, Laura Giacomelli, Giorgio Di Rocco, Carlo Catalano, Ferdinando D’Ambrosio

Erschienen in: European Radiology | Ausgabe 5/2016

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Abstract

Objectives

To assess whether ultrasound elastography (USE) with strain ratio increases diagnostic accuracy of Doppler ultrasound in further characterisation of cytologically Thy3 thyroid nodules.

Methods

In two different university diagnostic centres, 315 patients with indeterminate cytology (Thy3) in thyroid nodules aspirates were prospectively evaluated with Doppler ultrasound and strain ratio USE before surgery. Ultrasonographic features were analysed separately and together as ultrasound score, to assess sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV). Receiver operating characteristic (ROC) curves to identify optimal cut-off value of the strain ratio were also provided. Diagnosis on a surgical specimen was considered the standard of reference.

Results

Higher strain ratio values were found in malignant nodules, with an optimum strain ratio cut-off of 2.09 at ROC analysis. USE with strain ratio showed 90.6 % sensitivity, 93 % specificity, 82.8 % PPV, 96.4 % NPV, while US score yielded a sensitivity of 52.9 %, specificity of 84.3 %, PPV 55.6 % and NPV 82.9 %. The diagnostic gain with strain ratio was statistically significant as proved by ROC areas, which was 0.9182 for strain ratio and 0.6864 for US score.

Conclusions

USE with strain ratio should be considered a useful additional tool to colour-Doppler US, since it improves characterisation of thyroid nodules with indeterminate cytology.

Key points

• Strain ratio measurements improve differentiation of thyroid nodules with indeterminate cytology

• Elastography with strain ratio is more reliable than ultrasound features and ultrasound score

• Strain ratio may help to better select patients with Thy 3 nodules candidate for surgery

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Titel: Strain ratio ultrasound elastography increases the accuracy of colour-Doppler ultrasound in the evaluation of Thy-3 nodules. A bi-centre university experience
verfasst von: Vito Cantisani
Piero Maceroni
Vito D’Andrea
Gregorio Patrizi
Mattia Di Segni
Corrado De Vito
Hektor Grazhdani
Andrea M. Isidori
Elisa Giannetta
Adriano Redler
Fabrizio Frattaroli
Laura Giacomelli
Giorgio Di Rocco
Carlo Catalano
Ferdinando D’Ambrosio
Publikationsdatum: 04.09.2015
Verlag: Springer Berlin Heidelberg
Erschienen in: European Radiology / Ausgabe 5/2016
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-015-3956-0

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Strain ratio ultrasound elastography increases the accuracy of colour-Doppler ultrasound in the evaluation of Thy-3 nodules. A bi-centre university experience